Cost Of Consumables Research Articles

Financial analysis of minimally invasive sacrocolpopexy compared with native tissue vaginal repair with concomitant hysterectomy.

Minimally invasive sacrocolpopexy (MISCP) is increasingly used for uterovaginal prolapse, but comparative cost data of MISCP versus native tissue vaginal repair (NTR) are lacking. The objective was to determine the cost difference, from a hospital perspective, between MISCP and NTR performed with hysterectomy for uterovaginal prolapse. This was a retrospective cohort study at a tertiary care center of women who underwent NTR or MISCP with concomitant hysterectomy in 2021. Hospital charges, direct and indirect costs, and operating margin (revenue minus costs) were obtained from Strata Jazz and compared using SPSS. A total of 82 women were included, 33 MISCP (25 robotic, 8 laparoscopic) versus 49 NTR. Demographic and surgical data were similar, except that MISCP had younger age (50.5 vs 61.1 years, p<0.01). Same-day discharge and estimated blood loss were similar, but operative time was longer for MISCP (204 vs 161 min, p<0.01). MISCP total costs were higher (US$17,422 vs US$13,001, p<0.01). MISCP had higher direct costs (US$12,354 vs US$9,305, p<0.01) and indirect costs (US$5,068 vs US$3,696, p<0.01). Consumable supply costs were higher with MISCP (US$4,429 vs US$2,089, p<0.01), but the cost of operating room time and staff was similar (US$7,926 vs US$7,216, p=0.07). Controlling for same-day discharge, anti-incontinence procedures and smoking, total costs were higher for MISCP (adjusted beta = US$4,262, p<0.01). Mean charges (US$102,060 vs US$97,185, p=0.379), revenue (US$22,214 vs US$22,491, p=0.929), and operating margin (US$8,719 vs US$3,966, p=0.134) were not statistically different. Minimally invasive sacrocolpopexy had higher costs than NTR; however, charges, reimbursement, and operating margins were not statistically significantly different between the groups.

A Novel Single-arm Single-port Micro-traumatic Laparoscopic Robotic Surgical System

As the robotic assisted single port surgery arousing attention, a novel single-arm single-port micro-traumatic laparoscopic robotic surgical system is proposed in this study. From the perspective of the mechanics, joints with high rigidity and high reliability were utilized to realize the remote center of motion (RCM). Besides, the cost of consumables was reduced by adding the support of the rigid endoscope. From the perspective of the algorithm, high-precision motion control method and feedback force protection mechanism were implemented. The effectiveness of the aforementioned characteristics were verified by five clinical experiments of cholecystectomy. The results showed that the system is able to reduce the amount of bleeding, accelerate the patient recovery, reduce the infection risk and shorten the learning period. The robotic surgical system had significant clinical application value.

Smart Quantum Tunneling Composite Sensors to Monitor FKM and FFKM Seals.

Operators of industrial machinery relentlessly pursue improving safety, increasing productivity, and minimizing unplanned downtime. Elastomer seals are ubiquitous components of this machinery. In general, static seals are designed to be compressed at a fixed level of compression, taking gland geometry, loading condition, temperature range of operation, fluid media exposure, and other factors into account to ensure the safe operation of equipment. Over time, seals experience compression set, chemical-induced swelling, erosion, and other phenomena which can compromise the compressive force generated by the seal and cause leaking. This is particularly important in critical applications, where high pressure, high temperature, and aggressive media are present, and fluorinated elastomers are common materials for seals. Further, changes in operating conditions at manufacturing plants, either intentional or through regular process variation, create unknown operating conditions for seals. This unknown and variable application environment makes seal performance hard to predict. Therefore, machinery utilizing seals is, at best, serviced preventatively at certain intervals, where seals are removed, and the remaining useful life of the seal is unknown. This leads to unnecessary machinery downtime and increases consumable costs for manufacturers. In the worst case, the seal is run to failure, creating machinery and plant safety concerns. Both scenarios are undesirable for manufacturers using industrial machinery. This paper reports on the development of "smart" intrinsic self-sensing seals, which enable performance monitoring of the compression behavior of seals while in use. In addition, this paper examines quantum tunneling elastomeric composites (QTC) to demonstrate a method of component performance monitoring by modifying the underlying elastomeric material itself. This paper studies QTC sensor-based fluorinated (FKM) and per-fluorinated (FFKM) compositions, which are modified to incorporate varying levels of carbon nanostructure (CNS) material. The resulting seal's resistive properties are shown to be a function of the level of compression, the first time this phenomenon has been demonstrated in high-performing FKM and FFKM seal materials.

Про лазерний технологічний комплекс на машинобудівному підприємстві

The geography of manufacturers of laser devices available for the Ukrainian market is analyzed. The field of application of laser systems at mechanical engineering enterprises is quite wide: heat treatment, welding, cutting, marking, piercing, surfacing and surface alloying. One of the most promising, accurate and productive laser systems at a mechanical engineering enterprise is a laser technological complex. The modern configurations of laser technological complexes, which are used at mechanical engineering enterprises, are considered. A review of sources for generating a beam using a diode laser, as the pumping method most widespread in mechanical engineering, is carried out.The advantages of using laser technological complexes at a mechanical engineering enterprise are considered. The features of the operation of this equipment and potential disadvantages are indicated. We are talking about cutting modes, which simultaneously depend on five or more settings; the quality of oxygen, air or shielding gas used during cutting; ambient temperature during equipment operation; safety features during work. Ways to eliminate potential drawbacks are proposed.Despite the presence of peculiarities of operation of laser technological complexes, they ensure high quality and productivity of production of sheet metal parts in mass production compared to stamping equipment. The laser technological complex provides processing of sheet metals of different thicknesses, different external overall dimensions, within the working table, and different brands of non-ferrous and ferrous metals, which allows it to be used effectively in single production. Also, to the positive qualities of laser installations, you can add insignificant costs for reconfiguring the equipment for the production of new products and the low cost of consumables.

Evaluation of the Effectiveness of Diagnosing a New Coronavirus Infection during the Period of Seasonal Incidence Using the “Hypercube” Mathematical Model

Abstract Background: With the emergence of new strains of coronavirus and the easing of previously imposed anti-COVID restrictions, it is important to respond quickly and ensure sufficient coverage of laboratory tests for people who come into contact with patients with coronavirus infection. Diagnostics by polymerase chain reaction (PCR) remain the most common and accessible method of laboratory confirmation of a new coronavirus infection COVID-19. The method has a huge number of positive aspects, but it is time-consuming. During an epidemiological outbreak, the speed at which a diagnosis is made is often crucial. In addition, the task of reducing material costs for reagents and consumables used in the analysis by PCR method is also relevant. Objective: The objective is to evaluate the effectiveness of the hypercube mathematical model application for diagnosing a new coronavirus infection COVID-19 by the PCR method. Materials and Methods: In the course of the work, 108 respiratory swabs were examined using the reverse transcription-PCR method; the swabs were tested by the classical method and using the hypercube mathematical algorithm. Results: By applying the group mixing method using the ’Hypercube’ mathematical model, when performing molecular genetic analyzes, we were convinced that it is inexpedient to use sample pooling during the seasonal peak incidence of coronavirus infection. Applying the method, the cost of reagents, consumables, and time increases by at least 1.5–2 times since all our studies required conducting additional clarifying tests. At the same time, our results show that the hypercube pooling technique does not affect the analytical sensitivity. Conclusion: The use of the Hypercube mathematical algorithm for SARS-CoV-2 virus testing during an increase in seasonal incidence is a mostly unpromising strategy since it increases the time of PCR analysis and the cost of reagents and consumables, as well as slows down the validation of the result.

МОНИТОРИНГ И ОЦЕНКА МИКРОБИОЛОГИЧЕСКОЙ ДИАГНОСТИКИ ТУБЕРКУЛЁЗА: РЕСУРСЫ И ДЕЯТЕЛЬНОСТЬ МИКРОБИОЛОГИЧЕСКИХ ЛАБОРАТОРИЙ

Significance. The system of microbiological diagnostics is of key importance for organizing microbiological diagnostics in accordance with the modern recommendations, and fulfilling political commitments of the Russian Federation within the framework of the End TB Strategy Purpose: to assess the availability, use and results of the modern methods of microbiological diagnostics of tuberculosis in Russia in 2021. Material and methods. The study has analyzed forms #7-TB, ВР-4БЛ, ВР-1Ф of official statistical observation, results of external quality assessment of laboratories (Interlaboratory comparison system “Federal System of External Quality Assessment of Clinical Laboratory Testing (FSEQA)”). Results. The share of patients with pulmonary tuberculosis with a smear positive Ziehl-Nelsen, detected in medical organizations providing primary health care (PHC) decreased to 12.8%, while the share of new smear positive pulmonary TB patients increased to 37.4%; the share of newly diagnosed patients with pulmonary tuberculosis with a positive result of sputum bacterioscopy among patients with cavities increased to 60.6%.The share of laboratories with satisfactory results of the FSEQA participation regarding smear microscopy increased to 92.8%; the share of laboratories with the confirmed quality increased to 14.3%. The culture coverage of new pulmonary TB patients equaled to 98.0%. Culture-based confirmation of the diagnosis was obtained in 55.3% of the patients; the share of smear positive new pulmonary TB patients with the negative culture result decreased to 3.8%. The share of laboratories participating in FSEQA increased to 44.5%; the share of laboratories that showed satisfactory results - up to 90.8%, the share of laboratories with the confirmed quality - up to 40.4%. The coverage with molecular genetic testing added up to 90.8%. The drug susceptibility testing (DST) coverage equaled to 97.7%. The patient coverage with rifampicin resistance DST to fluoroquinolones reached 93.2%; coverage with pre-XDR-TB DST to linezolid - 35.0%, bedaquiline - 12.4%. Conclusion. Microbiological diagnostics of tuberculosis in PHC by smear microscopy is ineffective in modern conditions; there are prospects for its use in new Russian regions. The COVID-19 pandemic failed to produce any significant negative impact on the patient coverage with microbiological examination methods. In 2020–2021, the quality of bacterioscopic and culture testing for tuberculosis increased. DST coverage for bedaquiline and linezolid is poor; this does not allow to meet the current clinical guideline requirements. The cost of consumables per patient increased 3.1 times between 2015 and 2021.In the structure of financial expenses on TB microbiological diagnostics, consumables that require import substitution prevail. Scope of application. The study results can be used by heads of health authorities, chief physicians of TB facilities, heads of microbiological laboratories in order to increase effectiveness of TB care, timely detection of people excreting bacteria and MBT drug susceptibility testing.

Option appraisal of matrix-assisted laser desorption ionisation time of flight systems for a diagnostic microbiology laboratory

A major challenge for a clinical diagnostic bacteriology/mycology laboratory is to identify the causal microorganism to the species level within a limited time frame. Conventional microbiological techniques such as culture, Gram stain, biochemical tests and molecular tests like 16S rRNA analysis can take days to yield the desired result. Matrix-assisted laser desorption ionisation-time of flight (MALDI-TOF) mass spectrometry (MS) system serves as a potential solution as it can provide accurate identification results within minutes. While several MALDI-TOF MS instruments are in the market, choosing the right system and comparing all the relative pros and cons can be difficult. Our present study focuses on this aspect as we have performed an option appraisal between two leading MALDI-TOF MS instruments, namely the MBT Sirius IVD system (Bruker) and the VITEK-MS system (Biomerieux). We have discussed all the parts of MALDI-TOF systems in detail followed by a cost analysis categorising the total cost into capital and consumable cost which will provide clarity of the estimated budget. We have also discussed the principle involved in organism identification and have compared the two systems concerning technology, accuracy, database, optimal operating conditions, etc. This article aims to provide readers with a better understanding of MALDI-TOF systems and facilitate informed decision-making regarding the acquisition of such systems.

Costs Related to Diverting Ileostomy After Rectal Cancer Surgery: A Population-Based Healthcare Cost Analysis Based on Nationwide Registers.

Low anterior resection for rectal cancer often includes a diverting loop-ileostomy to avoid the severe consequences of anastomotic leakage. Reversal of the stoma is often delayed, which can incur health-care costs on different levels. The aim is to, on population basis, determine stoma-related costs, and to investigate habitual and socioeconomic factors associated to the level of cost. Multi-register design with data from the Swedish Rectal Cancer Registry, the National Prescribed Drug Register, Statistics Sweden and cost-administrative data from the National Board of Health and Welfare. Data was gathered for 3564 patients with rectal cancer surgery 2007 to 2013, for 3 years following the surgery. Factors influencing the cost of inpatient care and stoma-related consumables were assessed with linear regression analyses. All monthly costs were higher for females (consumables P < .001 and in-patient care P = .031). Post-secondary education (P = .003) and younger age (P = .020) was associated with a higher cost for consumables while suffering a surgical complication was associated with increased cost for inpatient care (P < .001). Patients who had their stoma longer had lower monthly costs (consumables P < .001 and in-patient care P < .001). Female gender, longer duration of stoma, young age, and higher education are associated with higher costs for the care of a diverting stoma after rectal cancer surgery. This study does not allow for analyses of causality but the results together with deepened analyses of underlying reasons form a proper basis for decisions in health care planning and allocation of resources. These findings may have implications on the debate of equal care for all.

Cost of Therapeutic Care for Patients on Maintenance Hemodialysis in a Public Hospital in Congo Brazzaville in 2022

Objective: Evaluate the cost of CRD (Chronic Renal Disease) management at the dialysis stage, in a public hospital in Congo Brazzaville. Patient and method: It was a longitudinal and descriptive study of 7 months, which took place over the period from February 1 to August 31, 2022, in the Nephrology-Hemodialysis department of HGELBO It focused on 35 patients identified in a way exhaustive. Socio-demographic and clinical information and expenses incurred over 3 months were collected from medical records and during individual interviews using pre-established survey sheets. SPSS 22 software was used for data analysis and processing. Results: Of the 35 patients, 26 were men, i.e., a sex ratio of 2.9. The mean age was 51.2 ± 12.3 years. Only 3 patients (9%) had health insurance and 52.2% of working patients had lost their job after starting dialysis. The median monthly cost of a chronic HD patient was 630,800 CFA Francs. Direct expenses amounted to 589,367 CFA Francs, they represented 93.4% of the total cost and are dominated by the cost of dialysis consumables (56.9%). The monthly median indirect cost was evaluated at 60,000 CFA Francs and represents 9.2% of the overall cost. The average cost of an HD session was evaluated at 31,219.4 CFA Francs. The total annual cost of the patient in HD maintenance was estimated at 7,569,600 CFA Francs. Conclusion: The cost of caring for HD patients is high. The cost of managing CR at the dialysis stage is beyond the reach of most patients, so there is a need to implement strategies to prevent and manage ESRD in our setting.

Tampering of environmental protection systems on vehicles: Status quo and perspectives

Pollutant emissions of road vehicles have significantly reduced thanks to the environmental protection systems (EPS), but tampering with these systems can lead to very low efficiency. In the DIAS project, it was found that there is a substantial market for both light- and heavy-duty vehicles and non-road mobile machinery. The main motives are reduction of costs for repair, consumables and downtime, performance tuning, and increase of the exhaust sound level. Tests with several tampering devices revealed that tampering could deactivate or enable the removal of the EPS, and prevent necessary repair of components without malfunction indication and driver inducement occurring, although several tampering devices and services were not successful. Finally, the testing program enabled the definition of the necessary countermeasures to detect and prevent tampering with these systems.

A retrospective cohort study on the cost-effectiveness analysis of kidney transplantation compared to dialysis in Cameroon: evidence for policy.

chronic kidney disease affects one in ten adults in Cameroon. Haemodialysis was the only renal replacement therapy (for adults) in Cameroon and its sub-region until November 10, 2021. Thereafter through May 2022, the Yaoundé General Hospital successfully completed four living-donor kidney transplants. This paper examines policy implications. medical records of cohorts of kidney failure patients who started haemodialysis at Yaoundé General Hospital in 2012 (n=106) and 2017 (n=118) were abstracted retrospectively through 2021 and their survival analyzed with Microsoft Excel and Kaplan-Meier curves. Using hospital data, the literature, and price indexes, the annual medical cost per patient of dialysis and living-donor kidney transplantation in 2022 prices was derived. the 9.5-year survival rate for the 2012 cohort was 11% and the 5-year rate for the 2017 cohort was 18%. Annual haemodialysis cost per patient averaged $17,681 (26.5% from households and 73.5% from government). Initial transplantation costs averaged $10,530 per patient, all borne by the government. Under the brand-drug option, first-year transplantation follow-up costs $19,070 (4% for laboratory and 96% for drugs). annually, haemodialysis in Cameroon costs per patient 12 times the country's average income ($1,537), driven especially by the costs of equipment purchase, maintenance, and consumables. Cameroon's initial cost of transplantation is lower than in other African countries. Generic drugs could lower annual follow-up costs by 89%. If Cameroon could achieve long-term survival with generic drugs after kidney transplantation, that modality would become a reasonable option for selected kidney failure patients (e.g. younger and without other comorbidities).

Cost minimization analysis of nasopharyngoscope reprocessing in community practice

BackgroundReprocessing of nasopharyngoscopes represents a large financial burden to community physicians. The aim of this study was to perform a cost analysis of nasopharyngoscope reprocessing methods at the community level.MethodsElectronic surveys were distributed by email to community otolaryngologists. Surveys were comprised of 14 questions assessing clinic size, nasopharyngoscope volume, scope reprocessing method and maintenance. Four manual techniques were evaluated: (1) soak with ortho-phthalaldehyde solution (Cidex-OPA; Advanced Sterilization Products, Johnson and Johnson Inc., Markham, Canada), (2) soak with accelerated hydrogen peroxide solution (Revital-Ox; Steris Canada Inc., Mississauga, Canada), (3) disinfection with chlorine dioxide wipe (Tristel Trio Wipes System; Tristel plc., Cambridgeshire, UK), (4) UV-C light system (UV Smart, Delft, The Netherlands). All costs are reported in CAD, and consumable and capital costs for reprocessing methods were obtained from reported vendor prices. Time costs were derived from manufacturer recommendations, the Ontario Medical Association Physician’s Guide to Uninsured Services, and the Ontario Nurses Association Collective Agreement. Cost analyses determined the most cost-effective reprocessing method in the community setting. Sensitivity analyses assessed the impact of reprocessing volume and labour costs.ResultsThirty-six (86%) otolaryngologists responded and answered the survey. The cost per reprocessing event for Cidex-OPA, Revital-Ox, Tristel and UV system were $38.59, $26.47, $30.53, and $22.74 respectively when physicians reprocessed their endoscopes themselves. Sensitivity analyses demonstrated that Revital-Ox was the least costly option in a low volume, however, the UV system remained the most cost effective in higher volumes. The cost per reprocessing event when done by clinic staff was $5.51, $4.42, $11.23 and $6.21 for Cidex-OPA, Revital-Ox, Tristel and the UV system.ConclusionsThe UV light system appears to be the most cost-effective method in high volumes of reprocessing, and Revital-Ox is cheaper in lower volumes and when performed by clinic staff rather than physicians. It is important to consider the anticipated work volume, shared clinic space and number of co-workers prior to choosing a reprocessing method.Graphical

DETERMINATION OF PHENOLIC-TYPE ANTIOXIDANT ADDITIVES IN FRESH INSULATING OILS BY IR SPECTROMETRY ON A LIQUID EXPRESS ANALYZER ATTACHMENT

For more than 120 years, transformer oil, derived from oil, has been most widely used as an insulating and heat dissipating medium in oil-paper insulated electrical equipment. During operation, under the influence of such factors as elevated temperature of the windings, electric field, contact with air oxygen and metal parts of the equipment, the oil is oxidized resulting in the deterioration of its electrical insulation properties and creating the risk of failure of expensive electrical equipment. In order to slow down the oxidation process and extend the life of the oil, the inhibiting additive ionol is added. However, in previously published works we showed that the additive ionol itself also undergoes decomposition with the formation of other phenolic compounds, which presence acts as an additional indicator of intensive aging of the liquid dielectric. Therefore, it is advisable to control in fresh transformer oils not only the content of ionol itself but also the presence of its degradation products showing similar inhibitory properties. A method of quantitative determination of ionol (2,6-di-tret-butyl-4-methylphenol) as well as 2,6-di-tret-butylphenol is proposed in the present work. The method of analysis is based on the IR spectrometry using a liquid express analysis attachment. The proposed method has a number of advantages over other methods, including standardized methods, i.e. speed; simplicity; safety, since chemical reagents are not required; low cost of consumables.

Comparison of Operation and Maintenance of Floating 14 MW Turbines and Twin 10 MW Turbines

Abstract Turbine ratings in the past decade have grown unexpectedly fast. In 2021, Siemens Gamesa and GE revealed their new 14 MW turbine models, and it is predicted that this is not yet the rating limit that turbines can reach. Increased turbine ratings can also be achieved by putting two turbines on a single foundation. This study analyzes how operation and maintenance (O&amp;M) would differ if a floating wind farm had twin 10 MW turbines installed on each substructure, instead of a single 14 MW turbine. This study demonstrates how the strategic O&amp;M simulation tool compass can be used to perform this comparison. Assumptions regarding the O&amp;M of twin turbines were estimated with the major floating twin turbine developer Hexicon AB. This study analyzed four cases—a case with 35 twin 10 MW turbines, and three cases with 50 single 14 MW turbines—to understand the potential effect of increased consumable costs, spare part lead times, and maintenance durations. All cases had the same wind farm capacity of 700 MW. The results show that O&amp;M for cases with single turbines is at least 4.5% more expensive than the case with twin turbines. The case with twin turbines also resulted in a higher availability than any other case. Additionally, results showed that operational expenditure (OPEX) for the cases with single turbines is at least 6.0% higher in scenarios with single turbines than in the twin turbine scenario. The biggest cost contributors to the difference between scenarios were craft costs, particularly cable laying vessels and tugs. Due to the higher number of cables required for the scenario with single turbines, there is more frequent mobilization of cable vessels for cable repairs.

Cost of wastewater-based environmental surveillance for SARS-CoV-2: Evidence from pilot sites in Blantyre, Malawi and Kathmandu, Nepal.

Environmental surveillance of rivers and wastewater for SARS-CoV-2 detection has been explored as an innovative way to surveil the pandemic. This study estimated the economic costs of conducting wastewater-based environmental surveillance for SARS-CoV-2 to inform decision making if countries consider continuing these efforts. We estimated the cost of two SARS-CoV-2 environmental surveillance pilot studies conducted in Blantyre, Malawi, and Kathmandu, Nepal. The cost estimation accounted for the consumables, equipment, and human resource time costs used for environmental surveillance from sample selection until pathogen detection and overhead costs for the projects. Costs are reported in 2021 US$ and reported as costs per month, per sample and person per year. The estimated costs for environmental surveillance range from $6,175 to $8,272 per month (Blantyre site) and $16,756 to $30,050 (Kathmandu site). The number of samples processed per month ranged from 84 to 336 at the Blantyre site and 96 to 250 at the Kathmandu site. Consumables costs are variable costs influenced by the number of samples processed and are a large share of the monthly costs for ES (ranging from 39% to 72%). The relatively higher costs per month for the Kathmandu site were attributable to the higher allocation of dedicated human resources and equipment to environmental surveillance for SARS-CoV-2 compared to the Blantyre site where these resources were shared with other activities. The average cost per sample ranged from $25 to $74 (Blantyre) and $120 to $175 (Kathmandu). There were associated economies of scale for human resources and equipment costs with increased sample processing and sharing of resources with other activities. The cost per person in the catchment area per year ranged from $0.07 to $0.10 in Blantyre and $0.07 to $0.13 in Kathmandu. Environmental surveillance may be a low-cost early warning signal for SARS-CoV-2 that can complement other SARS-CoV2 monitoring efforts.

Challenges in setting up a primary human papillomavirus-DNA testing facility in a lower and middle income country: lessons learned from a pilot programme.

Detection of high-risk human papillomavirus (hrHPV) is the most sensitive test for the screening of cervical cancer. Although most high-income countries have adopted this strategy in their screening programme, there are a lot of barriers in low and middle-income countries (LMICs) in setting up this facility for screening. The lessons learned based on this experience can be useful for other LMICs in their first steps to integrate HPV testing into a screening programme. HPV testing using self-sampling was offered to eligible women residing in one district of Sikkim state. To implement the same, a testing laboratory was set up in the district and the challenges faced are listed. The cost of testing equipment, sampler and cold storage was beyond the budget capping. Setting up of the HPV testing lab accessible to study sites and referral centre was a difficult decision to make. Training the health care providers in their proficiency in triaging and treatment was challenging. Coordinating with community health workers and beneficiaries for effective screening and establishing referral linkages was not easy, as we expected. The cost of transportation, consumables and contingencies was higher due to the difficult terrain. The cost of the equipment and consumables for primary HPV screening can be reduced in bulk purchases through negotiations. Adequate knowledge of the terrain and economic implications of the area of interest is crucial during the budgeting of the programme. Collaborating with the state government, integration with the existing health system and repurposing the available resources are key for success. The barriers faced during implementation are stepping stones for improvement.

Near Infrared Light Source Versus Naked Eye Visualization for Establishing Intravenous Access in Neonates: A Randomized Control Trial

Objective: To compare efficacy of near infrared light (NIR) versus naked eye (NE) visualization for intravenous access in the neonates. Methods: This was a randomized controlled trial carried out in a tertiary care center in New Delhi, India from 2015 to 2017. A total of 480 admitted neonates, who required placement of intravenous catheter were randomized to receive intravenous access attempt with NE group or using NIR source group. Primary outcome was first attempt success rate of establishing intravenous access. Secondary outcomes were to compare the time to establish intravenous access, number of pricks taken, and cost of consumables used.Results: Of 240 neonates in each group the mean birth weight of neonates in NE group and NIR group being 1665 ± 820 grams and 1600 ± 778 grams, respectively (p-value = 0.363). Mean gestational age of neonates were 31.78 ± 3.9 weeks in NE group and 31.79 ± 3.9 weeks in NIR group (p-value= 0.972). First-attempt success rate in NE group and NIR group was 122 (50.8%) and 124 (51.7%) respectively. The median(IQR) of time taken to establish intravenous access was 37.5 (13- 134.7) sec and 43 (17-221.2) sec in the NE group and NIR group, respectively (p-value = 0.307). There was no significant difference between the groups for secondary outcomes. Conclusion: Use of NIR source as compared to NE visualization, for establishment of intravenous access in neonates, does not improve first attempt success rate. Keywords: Near Infrared Light, Neonate, Vein Viewer. Clinical Trial Registry #: CTRI/2017/01/007693

Low Resource Integrated Platform for Production and Analysis of Capped mRNA.

The existing platform for large-scale mRNA production is fast, but consumable costs, process technicality, and complexity represent key bottlenecks limiting global mRNA biologics manufacturing. Another challenge is the lack of a consolidated platform for mRNA product characterization and assays that meet regulatory requirements. Bridging these innovation gaps to simplify processes and reduce cost would improve mRNA biologics manufacturability, especially in low-resource settings. This study develops a "cotranscriptional" capping strategy that utilizes T7 RNA polymerase, and the Vaccinia Capping System to synthesize and cap mRNA. We created an "integrated reaction buffer" that supports both capping enzymes for catalytic and in vitro transcription processes, enabling one-pot, two-step capped mRNA synthesis. Additionally, we report a novel, one-step analytic platform for rapid, quantitative, capped mRNA analysis. The assay involves target mRNA segment protection with cheap DNA primers and RNase digest of non-hybridized or non-target sequences before analysis by single nucleotide-resolving urea-polyacrylamide gel electrophoresis (PAGE). The integrated approach simplifies production processes and saves costs. Moreover, this assay has potential applications for mRNA analyses and post-transcriptional modification detection in biological samples. Finally, we propose a strategy that may enable unparalleled sequence coverage in RNase mass mapping by adapting the developed assay and replacing urea-PAGE with mass spectrometry.

Estimating the economic cost of carbapenem resistant Enterobacterales healthcare associated infections in Singapore acute-care hospitals.

Quantifying the costs of hospital associated infections (HAIs) caused by carbapenem-resistant Enterobacterales (CRE) can aid hospital decision makers in infection prevention and control decisions. We estimate the costs of a CRE HAI by infection type and the annual costs of CRE HAIs to acute-care hospitals in Singapore. We used tree diagrams to estimate the costs (in Singapore dollar) of different CRE HAI types from the health service perspective and compared them to the costs of carbapenem-susceptible HAIs. We used two approaches to estimate costs-direct costs of consumables for infection prevention and treatment; and costs associated with lost bed days. Cost of a HAI were extrapolated to annual CRE HAI incidence in Singapore acute-care hospitals to estimate the annual cost to the hospitals. We found that the cost of a CRE HAI based on direct cost and lost bed days are SGD$9,913 (95% CI, SGD$9,431-10,395) and SGD$10,044 (95% CI, SGD$9,789-10,300) respectively. CRE HAIs are markedly higher than the carbapenem-susceptible HAIs for all infection types. In both approaches, CRE pneumonia was the costliest infection. Based on a CRE HAI incidence of 233 per 100,000 inpatient admissions, CRE HAIs costed SGD$12.16M (95% CI, SGD$11.84-12.48M) annually based on direct costs, and SGD$12.33M (95% CI, SGD$12.01-12.64M) annually based on lost bed days. In conclusion, we described the cost of CRE HAIs in Singapore hospitals and identified infections with the highest costs. The findings may be useful in informing future economic evaluations of competing CRE HAI prevention and treatment programmes.

Contactless measurement of current-voltage characteristics for silicon solar cells

The measurement of the current-voltage (IV) characteristics is the most important step for quality control and optimization of the fabrication process in research and industrial production of crystalline silicon solar cells. We propose a methodology to determine the IV characteristics of silicon solar cells in a contactless way. We summarize the theory behind the method, describe the experimental setup and prove the validity of the concept by comparing contactless with conventionally measured IV results. We demonstrate that the differences in open-circuit voltage, short-circuit current, fill factor, and efficiency are smaller than 2.5 %rel for a test set consisting of four passivated emitter and rear cells (PERC cells), two tunnel oxide passivated contact (TOPCon) cells and a silicon heterojunction (SHJ) cell. The methodology eliminates mechanical stress on the solar cells and the time required for contacting the cells, does not require broad busbars for contacting and, hence, enables to reduce the silver consumption, simplifies the measurements of shingle cells and potentially shortens the required time, avoids shading by the contact units and consumable costs for the probes, and yields additional information (reflectance spectrum, quantum efficiency) on the cells compared to conventional IV testing. The methodology might facilitate further applications in the future, e.g., contactless outdoor testing of modules, individual diagnosis of failed cells within a module, and on-the-fly IV measurements of cells.